Analysis of clinical practice guidelines in Multiple Sclerosis using the Agree tool (P3.041)

Objective: To assess quality of clinical practice guidelines (CPGs) for Multiple Sclerosis (MS) Background: AGREE II is a widely used instrument designed to evaluate CPGs and therefore classify them as recommendable or not. The Peruvian committee for the development of the CPG for MS used this tool to evaluate which guidelines were most appropriate to base their recommendations on. Design/Methods: Search was performed in Pubmed/Medline, Embase, Scopus, The Cochrane Library, Scielo, Lilacs, Hinari, Bireme, Lipecs, NGC, NHS NeLM, Guias salud de Espana, NICE, SIGN, UpToDate, in English and Spanish from 2010 to 2015. Keywords used for the search were: multiple sclerosis, systematic OR metanalysis, clinical trial, randomized clinical trial, pragmatic clinical trial or multicenter study. CPGs were evaluated using AGREE II by at least 2 reviewers (neurologists from the Peruvian Society of Neurology experts in MS). Intraclass correlation coefficient (ICC) was evaluated for every CPG. Results: Twenty-one CPGs met criteria for analysis. Fifteen CPGs were evaluated by 4 reviewers, 4 CPGs were evaluated by 3 reviewers and 2 CPGs were evaluated by 2 reviewers. Mean values for each domain were: scope and purpose (75±14.1), stakeholder involvement (52.29±17.4), rigor in development (46.1±18.9), clarity and presentation (73.6±13.4), applicability (30.9±14.5) and editorial independence (62.1±26.2). ICC between reviewers was poor in 4/21 CPGs. One CPG presented slight correlation (0.01–0.20), six CPGs presented fair correlation (0.21–0.40), eight CPGs presented moderate correlation (0.41–0.60) and two CPGs presented substantial correlation (0.61–0.80). CPG of CEMCAT 2012 (6 domains >60%) and CPG of Latin America MS experts’ forum 2014 (4 domains >60%) were recommended. Conclusions: Scope and purpose, clarity and presentation and editorial independence obtained higher scores in comparison to other domains. Agreement using AGREE II tool differed from guideline to guideline. AGREE II allows a balanced and standardized evaluation of CPG for the future development of guidelines for MS. Study Supported by: self financed Disclosure: Dr. Villafuerte Trisolini has nothing to disclose. Dr. Duque has nothing to disclose. Dr. Adrianzen Alvarez has nothing to disclose. Dr. Vizcarra Escobar has nothing to disclose. Dr. Zamudio has nothing to disclose. Dr. Caparo has received personal compensation for activities with Merck, Serio, Bayer, Novartis, Stendhal and Genzyme as a speaker advisor. Dr. Cruz has nothing to disclose. Dr. Huertas has nothing to disclose. Dr. Chucan has received personal compensation in an editorial capacity for Genzyme. Dr. Gonzalez Gamarra has nothing to disclose. Dr. Meza-Vega has nothing to disclose. Dr. Montalvan Ayala has nothing to disclose. Dr. Mori has received personal compensation for activities with Novartis, Abbot, Axon Pharma, and Roemers. Dr. Rivara Castro has nothing to disclose. Dr. Rojas Huerto has received personal compensation for activities with Bayer as a speaker and Genzyme as an advisor. Dr. Castro Suarez has nothing to disclose.